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PubMedDate not supplied

EXTEND: a prototype expert system for teaching nursing diagnosis.

In this article, the development and uses of EXTEND (Expert system for Education in Nursing Diagnosis), a computer assisted instruction package for teaching nursing diagnosis using the categories proposed by the North American Nursing Diagnosis Association, are described. EXTEND provides a knowledge base that is able to deduce a nursing diagnosis from case factors and extends the normal use of expert systems beyond diagnosis to diagnosis education by providing answers to student questions about a simulated client and by guiding them through the diagnostic task. Furthermore, EXTEND allows the teacher to record the steps taken by students in the assessment and diagnosis of the simulated client, and use this as the focus of further discussion. The system is a response to the problems of teaching nursing diagnoses cited in the professional literature.

Computer-Assisted Instruction↗
PubMed1995

[Electronic data processing in nursing: specific needs related to rostering programs in nursing].

Electronic data processing is taking over in the nursing domain in German hospitals. This is due, not only to the fact that computer hard- and software are getting better and cheaper, but also due to the legal demands of the new health legislation. Neither nurse-managers nor the nurses themselves are adequately prepared for this technical innovation or its implications. The dominant influence of management-interests leads to the danger that criteria relevant to the content of nursing fail to be taken into account. Consequently the quality of care may suffer. The Ministry for environment, energy, youth, family and health has commissioned the Agnes Karll Institute for Nursing Research to identify software features specific for the requirement of nurses. The study focuses on rostering programs for nursing staff allocation, in relation to the workload and on conditions which have to be met to make software nurse-friendly. Selected, important results are reported.

Germany↗
PubMed1995

The Scenario-Based Engineering Process (SEP): a user-centered approach for the development of health care systems.

The Scenario-based Engineering Process (SEP) is a user-focused methodology for large and complex system design. This process supports new application development from requirements analysis with domain models to component selection, design and modification, implementation, integration, and archival placement. It is built upon object-oriented methodologies, domain modeling strategies, and scenario-based techniques to provide an analysis process for mapping application requirements to available components. We are using SEP in the health care applications that we are developing. The process has already achieved success in the manufacturing and military domains and is being adopted by many organizations. SEP should prove viable in any domain containing scenarios that can be decomposed into tasks.

Artificial Intelligence↗
PubMed1996

Legal issues of the electronic dental record: security and confidentiality.

Computer-based, electronic dental record keeping involves complex issues of patient privacy and the dental practitioner's ethical duty of confidentiality. Federal and state law is responding to the new legal issues presented by computer technology. Authenticating the electronic record in terms of ensuring its reliability and accuracy is essential in order to protect its admissibility as evidence in legal actions. Security systems must be carefully planned to limit access and provide for back-up and storage of dental records. Carefully planned security systems protect the patient from disclosure without the patient's consent and also protect the practitioner from the liability that would arise from such disclosure. Human errors account for the majority of data security problems. Personnel security is assured through pre-employment screening, employment contracts, policies, and staff education. Contracts for health information systems should include provisions for indemnification and ensure the confidentiality of the system by the vendor.

Computer User Training↗
PubMedDate not supplied

Bibliography database managers. A comparative review.

Bibliography database managers (BDMs) are used to manage information resources: specifically, to maintain a database of references and create bibliographies and reference lists for written works. This comparative review provides an overview of BDMs and capsule reviews of five programs: EndNote Plus 2.0; Library Master 3.0; Papyrus 7.0.11; Pro-Cite 2.2.1; and Reference Manager 6.02.

Bibliographies as Topic↗
PubMed1996

Rule induction and instance-based learning applied in medical diagnosis.

Machine learning methods have been applied in a variety of medical domains in order to improve medical decision making. Improved medical diagnosis and prognosis can be achieved through automatic analysis of patient data stored in medical records, i.e., by learning from past experience. Given patient records with corresponding diagnoses, machine learning methods are able to classify new cases either through constructing explicit rules that generalize the training cases (e.g., rule induction) or by storing (some of) the training cases for reference (instance-based learning). This paper presents the methodologies of rule induction and instance-based learning and their application to medical diagnosis, in particular, the problem of early diagnosis of rheumatic diseases. It also discusses the possibility to use existing expert knowledge to support the learning process and the utility of such knowledge.

Algorithms↗
PubMedDate not supplied

A computerized method of describing phase-related interactive events: infant feeding as an example.

A generalizable, computerized method has been designed to describe in detail interactive events that occur within phases of a process involving two or more interactants. The objectives of the method are: (A) visual discernment of patterns of events within and across phases through graphically displayed data and (B) summarization of events within phases for comparison of events across phases. Stages of the implementation of these objectives are illustrated with data obtained from observations of mother-infant feeding interaction. The method provides a means for an investigator to structure the exploration of patterns of behaviors in the context of the social activity in which the behaviors occur and to develop hypotheses about the data.

Arousal↗
PubMedDate not supplied

Computerized test development software a comparative review.

Nurse educators, searching for the best use of technology to facilitate the development and administration of tests, are confronted with a wide variety of computerized test development programs from which to choose. This article provides a comparative review of seven commercially available computerized test development programs: A+ Test Manager and Test Taker, AUTOGENT, CATSoftware System, LXR*TEST, MicroCAT, Question Designer for Windows, and Test Construction Set. Criteria for evaluating these programs including ease of use, psychometric properties, security, and system requirements are discussed. Issues associated with the implementation of computerized test development and computerized test administration are considered. It is imperative that nurse educators understand their goals for computerized test development and administration in the context of their own setting before purchasing a program.

Computer-Assisted Instruction↗
PubMed1996

Development and multi-institutional implementation of coding and transmission standards for health outcomes data.

Health care delivery institutions and providers, employers, and government agencies throughout the U.S. are sharing information and pooling resources in an attempt to produce reliable measurements of health outcomes. The rapid rate of growth in the collection and pooling of health outcomes data has prompted the need for standardization. The work of health care organizations and consortiums pooling data would be greatly facilitated by widely accepted standards for the coding and transmitting of outcomes data. Moreover, standards allow for the inter-operation of data capture products, data analysis tools, and data pooling services developed by a variety of different vendors. The Health Outcomes Institute (HOI) and Henry Ford Health System (HFHS) have developed and maintain a database of health outcomes questions which provides a mechanism for uniquely coding data elements. HFHS and the American Medical Group Association (AMGA) have created a software tool to facilitate the conversion and transmission of health outcomes data elements in an American Society for Testing and Materials (ASTM)/Health Level Seven (HL7) format, which incorporates HOI question standards.

Health Services Research↗
PubMedDate not supplied

High touch meets high tech. Distance mental health screening for rural youth using Teleform.

This article presents an overview of distance mental health screening using Teleform. This technology provides nurses with the ability to have questionnaires administered in one location then processed and scored rapidly at a location some distance away by using a facsimile system and Teleform. The authors examine the process of using Teleform, cite its advantages and disadvantages, discuss its application with rural youth, and suggest implications for school personnel and health-care providers. Technology has facilitated many changes in health-care delivery and increasingly will be instrumental in creating changes. Computer technology can help nursing deliver services swiftly to larger populations.

Adolescent↗
PubMed1997

Comparison of ResMed AutoSet (version 3.03) with polysomnography in the diagnosis of the sleep apnoea/hypopnoea syndrome.

In patients with the sleep apnoea/hypopnoea syndrome (SAHS), accurate and timely diagnostic evaluation and initiation of effective treatment is important. Therefore, an increasing number of limited sleep studies are now performed nowadays diagnosing the SAHS in typical patients. It was the aim of the present study to evaluate the diagnostic accuracy of one such system, the updated ResMed Sullivan AutoSet, against polysomnography. Sixty seven patients underwent full overnight polysomnography and simultaneous data acquisition with the AutoSet. Up to now, the AutoSet was designed for apnoea detection only. The new AutoSet, with software version 3.03, detects apnoeas if ventilation drops to <25%, and apnoeas+hypopnoeas if ventilation drops to <50%, compared with the recent average (100 s), using two independent detectors. A two page report with graphically displayed information on oximetry, snoring and breathing parameters, and an apnoea+hypopnoea index (AHI) and an apnoea index (AI) are provided at the end of each study night. There was a correlation between the AHI assessed by the AutoSet (AHI-AutoSet) and by polysomnography (AHI-PSG; r=0.95). The mean difference between the AHI-AutoSet minus the AHI-PSG was 4.2 (SD 7.2) respiratory events x h(-1) (p<0.001). The AutoSet identified patients with an AHI-PSG >20 events x h(-1) (a level of respiratory disturbance that would warrant consideration for treatment in most centres for sleep disorders), with a sensitivity of 97% and a specificity of 77%. The AutoSet was superior to oximetry alone. As event counting was similar between the two methods, the AHI-AutoSet may provide a reasonable indicator of the respiratory disturbance at night, especially when taking the patients graphic study report into consideration. In conjunction with full clinical information on the patients under investigation, the AutoSet might become a useful device in diagnosing the sleep apnoea/hypopnoea syndrome.

Body Mass Index↗